Physician wellness and burnout prevention need to be prioritized by hospitals and group practices.

The mission statements of most hospitals talk about caring for the patient. The focus is not on caring for the health care providers.

The culture of medicine has changed over the years; many of the changes have led to an increase in physician burnout.

The Happy MD encourages creating a burnout prevention working group that does 3 things: educate about burnout, establish a feedback mechanism whereby providers can identify causes of stress, and ‘get on it’.

Physician wellness is not prioritized by hospitals, either through financial funding or other means of support. In medical training, we are conditioned to diagnose and treat. We are always focused on problems. Wellness is something that we rarely deal with in our day-to-day practice. Many hospitals have physician wellness committees which, while well-intentioned, have little to no impact. Burnout prevention committees, on the other hand, often receive support, money, and the necessary protected time to make changes. Hospitals put their organizational backbone behind preventing burnout.

Mission statements in medicine.

A mission-led endeavor, where the mission is consciously created and you live it, is an extremely important success factor in any business, including health care.

The challenge is that in health care, the mission statement almost always focuses only on the patient. It might talk about quality of care, but it doesn’t mention any of the people who work inside the organization. This blind spot gives the leadership the ability to ignore the needs, or even abuse, the providers inside the system. We are conditioned that the patient comes first and that conditioning sets us up for burnout. If the patient always comes first, you can’t recharge your own energy levels and eventually, you won’t have anything more to give.

A mission statement is not supposed to be a static thing. It is not meant to be a half-day retreat, never to be looked at again. Organizations often have a mission statement posted on their websites, but employees are unfamiliar with it and had no part in crafting it.

The Happy MD mission is to give physicians the tools that they need to lower their stress levels and prevent burnout. Most of the time, doctors are simply running through the patients on their ‘gerbil wheel’, heads down, in survival mode without any thought of their mission. Physicians need to be aware of their mission and live it, if they want it to have any impact on what they’re doing.

Which job would you take?

One where you are working in an organization where all you are is an RVU generator and nobody really cares about you as a person. This job compensates very well.

Or another where you are part of a team and everybody has each other’s back. In this job, people care about their lives outside of medicine and everybody gets along.

The culture of medicine has changed over time, which has led to an increase in burnout. Previously, many were in small group practices which encouraged socialization outside of medicine and a culture of teamwork and camaraderie. Now, these small groups have been absorbed by hospitals and large medical groups. Nobody knows anybody else. There is a lack culture and cohesiveness, which contributes to burnout.

It’s a tragedy and a missed opportunity that the vast majority of healthcare organizations have no signs of caring about the health of the front line providers in their mission statements. The statement does not include wordage indicating that the organization supports the well being or happiness of the people who deliver the medical care. Nurses, medical assistants, and physicians are all taught, conditioned, and driven to take good care of their patients. It happens automatically, as long as the providers are healthy and have adequate energy stores. Most organizations do not support the wellness of the people providing the medical care.

Burnout is inevitable if you can’t shut out, “The patient comes first’, when you leave the office. If you are only focused on the patient, you can’t recharge yourself and perform at your best the next day.

How do we change the culture of medicine, so we aren’t caring just about patients; that we are also caring about ourselves and each other?

Socialize more often; don’t underestimate the power of pizza and beer. This encourages cohesiveness.

Form a burnout prevention working group which has 3 specific steps.

Fill the educational holes around burnout. Talking about burnout normalizes the conversation. 40% of physicians are suffering from burnout on any given day, but doctors fear showing weakness and rarely feel comfortable talking about stress or burnout.

Establish a feedback mechanism for front-line providers with the focus on their level of satisfaction. Ask the following questions in a survey. (The answers to these questions create the project list for the burnout prevention working group.)

On a scale from 1-10, what is your satisfaction with your current practice?

What are the 1st, 2nd, and 3rd most stressful things in your workday.

How would you describe the culture around here in one sentence?

What would you like the culture to be like?

Get on it. Address the issues that come up in the survey publicly, loudly, and get administrative support. Communicate every little bit of progress that is made. Repeat the surveys every year to ensure that you are always working on improving the things that people point out as causing stress.

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